that I have mr. case is failing new to us I don't think it's necessarily new worldwide but I found it interesting so I threw it in there so this is a
non-surgical patient this is a 92 year old guy this guy just simply asked dr. Hirsch one of our spine specialists when he saw him in clinic he was referred to us that you know all I really want to do dr. Hirsch no I'll never forget dr.
Hirsch she's a real good connector with his patients he turned him and said dr. Hurst's really all I want to do is take walks with my grandchildren which he was completely unable to do so I'm not sure that this is a crazy
complex case like some of the extreme interventions that you've seen earlier but it's certainly a meaningful case for certain patients so because of that you can see that this patient obviously had a frame role
narrowing and I'll blow up these images and show you what that looks like in really what we're trying to do here because really kind of a not necessarily a non-surgical candidate but certainly a high-risk or poor surgical candidate
because of some other coexisting morbidities so again as we get the degenerative process sort of advances you can see and stole this from Verta flex just to give them credit you can see that this like some inflammation
here are the nerves creating all kinds of issues with them being able to ambulate you have this it's a traditional setup like a vertebroplasty gonna put the patient prone access through the back you can start to see
the delivery device here there's no pointer on this but you can note that the vertebral bodies is a little bit narrowed here at least in this sort of graphical illustration here you're advancing the inner spine spacer what
happens is it's actually screwed to a rod that goes through the delivery system fairly large delivery system trying to get the exact French size from the vendor because I forgot it today what we found out is it's it's about the
size of a dime according to them so so this is what it looks like efforts deployed on the top of the device you can see sort of not the blue sort of struts of fuel but on the top of the device it's lining the spinous processes
here but you can see that that's where they actual receptacle for the screw piece of it the male piece of it actually gets screwed into it and then you unscrew it after you deploy it so that's how it's actually left behind and
then this is what it looks like in profile so you can see sort of the stabilization around the spinous process it fits right in between the spinous process in the transverse process so we've seen this patient twice he's doing
great he thinks dr. Hirsh all of a sudden is a god I think he did this case in about an hour but now he's spending time with these grandchildren and like you know when we think about it it's it's
probably the reason why 99% of the people actually got into this field so this is a real rewarding case so I threw this in there for people and so just the images plain film you can see on the left this is not a vascular case but you
can see he could use some help there too and it turns out that you know you can see on the EMR aside what's going on with his nerves this is what it looks like obviously the post-op picture I'm pretty
good position in here and then this is where it looks like in the lateral position and since I'm as interested in listening to these guys as you guys that's all I have I have two cases but before I end I do want to thank dr.
Zubin irani he trained at the dotter Institute he's a really innovative procedures he does a lot of a high-level cases and dr. Hirsch was a world-class spine person and before I walk off the stage I want to thank some of my team
who's here from MGH we have our inventory managers some of our technical managers in one of our techs and it's always a pleasure to be able to bring them here so thank you guys for everything that you do
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